Controller for manipulation of instruments within a catheter

Abstract

An everting catheter system which includes an elongated outer catheter having an outer catheter lumen and an opening, an elongated inner catheter movable in the outer catheter lumen and having the inner catheter lumen adapted to receive an elongated instrument and an everting element coupled to the outer catheter and the inner catheter. With movement of the inner catheter in the outer catheter lumen, the everting element can be everted through the opening of the outer catheter. A controller is coupled to the inner catheter for moving the inner catheter in the outer catheter lumen and for moving the instrument in the inner catheter lumen.

We claim: 
     
       1. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel;   said peripheral surfaces of said drive and secondary wheels defining a groove for receiving the instrument; and   each of said drive wheel and said secondary wheel having an annular peripheral recess and the controller includes first and second members received in the annular peripheral recesses, respectively.   
     
     
       2. A controller as defined in claim 1 including a plurality of spaced projections on the peripheral surface of the drive wheel. 
     
     
       3. A controller as defined in claim 1 wherein said drive section is intermediate the mounting section and the handle section. 
     
     
       4. A controller as defined in claim 1 wherein the first and second members include first and second spaced alignment tabs for guiding the instrument between said wheels. 
     
     
       5. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel;   at least one of said peripheral surfaces of said wheels having a groove for receiving the instrument;   said drive section of the housing having an opening which exposes a portion of the peripheral surface of the drive wheel and the manual drive includes said portion of the peripheral surface of the drive wheel; and   said housing shielding the peripheral surface of the secondary wheel against contact with a user of the controller when the handle section is manually grasped.   
     
     
       6. A controller as defined in claim 5 wherein both said drive wheel and said secondary wheel define said groove, each of said drive wheel and said secondary wheel has an annular peripheral recess and the controller includes first and second members received in the annular peripheral recesses, respectively. 
     
     
       7. A catheter system comprising: an elongated catheter having a lumen adapted to receive an instrument, an opening communicating with the lumen and a proximal end portion;   a controller;   said controller including a supporting structure coupled to the proximal end portion of the catheter and a driving device on the supporting structure for moving the instrument in the lumen, said driving device including a movable endless member for contacting and driving the instrument longitudinally in the lumen and a wheel engagable with the instrument and cooperable with the movable endless member for moving the instrument longitudinally in the catheter; and   the controller including a coupling for rotatably coupling a first portion of the controller to a second portion of the controller such that rotation of the second portion of the controller relative to the first portion of the controller rotates the instrument in the lumen.   
     
     
       8. A system as defined in claim 7 wherein the movable endless member includes a drive wheel. 
     
     
       9. A system as defined in claim 7 wherein the moveable endless member has a region engageable by a thumb of an operator to impart a manual driving force to the movable endless member for moving the instrument longitudinally in the lumen. 
     
     
       10. A system as defined in claim 7 wherein the supporting structure includes a housing having a passage communicating with the lumen and adapted to receive the instrument, and the driving device is carried by the housing. 
     
     
       11. A system as defined in claim 10 wherein the passage in the housing has an axis, said portion of the controller includes a rotatable section of said housing rotatable generally about the axis of the passage, said driving device is carried by the rotatable section and is capable of gripping the instrument so that rotation of the rotatable section rotates the instrument relative to the inner catheter. 
     
     
       12. A system as defined in claim 10 wherein the movable endless member has a region engageable by a thumb of an operator to impart a manual driving force to the movable endless member for moving the instrument and a region of said housing extends proximally of said region of the movable endless member to form a handle adapted to be manually grasped. 
     
     
       13. A system as defined in claim 10 wherein at least a portion of the passage extends proximally of the driving device and the controller includes means in said passage for guiding the instrument from said portion of the passage to the driving device. 
     
     
       14. A system as defined in claim 7 wherein the movable endless member includes a drive wheel having a peripheral surface and a plurality of spaced projections on the peripheral surface of the drive wheel. 
     
     
       15. A catheter system as set forth in claim 7 wherein the elongated catheter is an inner catheter and the system includes an elongated outer catheter having an outer catheter lumen and an opening, the inner catheter is movable in the outer catheter lumen and an everting element is coupled to the outer catheter and the inner catheter whereby with movement of the inner catheter in the outer catheter lumen the everting element can be everted through the opening in the outer catheter. 
     
     
       16. A catheter system comprising: an elongated instrument;   an elongated catheter having a lumen for receiving the instrument, an opening communicating with the lumen and a proximal end portion;   a controller;   said controller including a supporting structure coupled to the proximal end portion of the catheter and a driving device on the supporting structure for contacting and driving the instrument longitudinally in the lumen;   interlocking projections and recesses on the instrument and driving device to provide a positive driving relationship between the driving device and the instrument; and   the elongated catheter is an inner catheter and the system includes an elongated outer catheter having an outer catheter lumen and an opening, the inner catheter is movable in the outer catheter lumen and an everting element is coupled to the outer catheter and the inner catheter whereby with movement of the inner catheter in the outer catheter lumen the everting element can be everted through the opening in the outer catheter.   
     
     
       17. A system as defined in claim 16 wherein the driving device includes a drive wheel having a peripheral surface and some of said projections and recesses are on said peripheral surface. 
     
     
       18. A system as defined in claim 16 wherein all the projections on said instrument are located proximally of the distal end of the instrument and along a length of the instrument which includes a region of the instrument which is at the driving device when the distal end of the instrument is adjacent the opening of the catheter. 
     
     
       19. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel; and   the passage having an axis and the controller including a coupling for rotatably coupling the drive section to the mounting section for rotation generally about the axis of the passage.   
     
     
       20. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel;   at least a portion of the passage extends proximally of the drive wheel and the secondary wheel, the controller includes first and second spaced alignment tabs for guiding the instrument between said wheels; and   said drive wheel and said secondary wheel define first and second annular spaces and the tabs are received in the annular spaces, respectively.   
     
     
       21. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel;   at least one of said peripheral surfaces of said wheels having a groove for receiving the instrument; and   the passage having an axis and the controller includes a coupling for rotatably coupling the drive section to the mounting section for rotation generally about the axis of the passage.   
     
     
       22. A controller as defined in claim 21 including means for holding the drive section against rotation relative to the handle section. 
     
     
       23. A controller for moving an elongated medical instrument in a catheter comprising: a housing having a passage extending therethrough which is adapted to receive an elongated medical instrument, said housing including a mounting section adapted to be coupled to a catheter, a drive section and an elongated handle section which is adapted to be manually grasped;   a drive wheel and a secondary wheel, each of said wheels having a peripheral surface, said wheels being rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and adapted to receive the instrument therebetween so that upon rotation of the drive wheel the instrument can be moved longitudinally in the passage;   a manual drive for manually rotating the drive wheel;   at least one of said peripheral surfaces of said wheels having a groove for receiving the instrument;   at least a portion of the passage extending proximally of the drive wheel and the secondary wheel;   first and second spaced alignment tabs for guiding the instrument between said wheels; and   said drive wheel and said secondary wheel defining first and second annular spaces and the tabs being received in the annular spaces, respectively.   
     
     
       24. An everting catheter system comprising: an elongated outer catheter having an outer catheter lumen and an opening;   an elongated inner catheter movable in the outer catheter lumen and having an inner catheter lumen adapted to receive an elongated instrument, the inner catheter having a proximal end portion;   an everting element coupled to the outer catheter and the inner catheter whereby with movement of the inner catheter in the outer catheter lumen the everting element can be everted through the opening in the outer catheter;   a housing coupled to the proximal end portion of the inner catheter whereby the inner catheter can be moved in the outer catheter lumen by movement of the housing, said housing having a passage communicating with the inner catheter lumen;   a driving device carried by the housing for moving the instrument in the inner catheter lumen relative to the inner catheter; and   the housing having an axis, said housing including a mounting section coupled to the proximal end portion of the inner catheter, a rotatable section and a coupling for coupling the rotatable section to the mounting section so that the rotatable section is rotatable generally about the axis of the passage, said driving device being carried by the rotatable section and being capable of gripping the instrument so that rotation of the rotatable section rotates the instrument relative to the inner catheter.